Understanding Ventricular Assist Devices

A ventricular assist device (VAD) helps the heart pump blood throughout your body. This device connects to one or both of the ventricles of your heart. A surgeon puts the VAD in place.

Your heart has 4 chambers. The 2 upper ones are called the right and left atria. The lower chambers are called ventricles. A VAD often supports the left ventricle so it can pump out enough blood to all parts of your body. Some VADs are designed to also work with the right ventricle or both ventricles.

Other names for a VAD are:

• Percutaneous ventricular assist device

• Mechanical circulatory support device

• Mechanical circulatory assist device

Why you may need a VAD

You may need a VAD if you have heart failure. This health problem means your heart can no longer pump the amount of blood your body needs to work properly. Your heart is too weak. Heart failure may happen if you have heart disease. Other health problems such as diabetes and high blood pressure can also damage and weaken the heart. A VAD can help you feel better and be more active.

A VAD can help you if you:

• Have heart failure that doesn’t get better with medicine or other treatments. For example cardiac resynchronization therapy (CRT)

• Have heart failure and are waiting for a heart transplant

• Have heart failure but can’t have a heart transplant

• Are recovering from heart surgery or a heart event, such as a heart attack

A VAD can be used for a short period of time, such as a few days or weeks. Or it can be used for months to years. People who are recovering from a heart attack or some other heart problem may need it only until their heart regains strength. This is called bridge to recovery therapy.

If you are waiting for a heart transplant, you may need a VAD until a donor heart becomes available. This use is called a bridge to transplantation. If you can’t have a heart transplant, you may use the VAD as long-term treatment for your heart failure. This is called destination therapy. You may not be able to have a heart transplant if you have kidney disease, liver disease, hepatitis, cancer, or other health problems.

How a VAD works

There are many kinds of VADs. But they all work in much the same way. Some VADs are used only in a hospital. Others can allow you to go home and resume many daily activities. Newer ones are smaller and more durable.

A VAD has several parts. It has a pump, tubes, a driveline, a control unit, and a power source. In older versions, the pump was located outside the body. For newer VADs, the pump is placed inside your abdomen below your heart. Tubes connect the pump to your heart, often to the aorta and to the left ventricle. These tubes direct blood from the pump through your heart out to the rest of your body.

A driveline, or cable, links the pump to the control unit outside your body. The driveline usually leaves  the body several inches from the navel. The control unit is powered by batteries. Or you can plug it into a power outlet. The control unit can alert you to problems with the pump. You carry the control unit and batteries with you in a holster.

What to expect when you have a VAD

A VAD can help you feel better and be more active. It can also help you live longer. But living with a VAD can be challenging. You will have to make some lifestyle changes. You will also need lots of follow-up care. Your care team will be there to help you manage this transition.

Once you have the VAD, you will see your care team for periodic checkups.  You will need to take medicine to prevent blood clots. You will also need regular testing to check your health and the condition of the VAD. You will have to do daily maintenance on the VAD and its parts. These activities may include:

• Cleaning and checking the equipment

• Recording VAD data and your vital signs, such as blood pressure

• Checking that the batteries are charged

• Changing the dressing around the driveline

With a VAD, it’s also important to focus on living a healthy lifestyle. You need to limit salt and eat foods good for your heart. A nutritionist can help you stick to a healthy eating pattern.

After you recover from surgery, physical therapy or cardiac rehab can help you regain or build strength. Regular exercise can keep you active longer. But you’ll need to avoid certain activities. These include swimming and contact sports. You also may not be able to drive for some time.